A novel in-plane technique ultrasound-guided pericardiocentesis via subcostal approach.
Needle Visualization
Pericardiocentesis
Subcostal Approach
Ultrasound-guided
Journal
The ultrasound journal
ISSN: 2524-8987
Titre abrégé: Ultrasound J
Pays: Italy
ID NLM: 101742146
Informations de publication
Date de publication:
21 May 2022
21 May 2022
Historique:
received:
02
03
2022
accepted:
01
05
2022
entrez:
21
5
2022
pubmed:
22
5
2022
medline:
22
5
2022
Statut:
epublish
Résumé
Cardiac tamponade occurs when fluid or blood, fills the pericardial space, and causes hemodynamic compromise due to compression of the heart. It is a potentially life-threatening condition, that requires rapid recognition and immediate treatment. Formerly, blind or surgical techniques were used, and it is associated with complications. Medical technology development has enabled us to perform the procedure safely, with the assistance of ultrasound devices. This article will highlight the novel use of an in-plane subcostal technique, as a safe option for pericardiocentesis in cardiac tamponade. A 50-year-old man presented to the emergency department (ED) with shortness of breath and shock. He was intubated for respiratory distress. His bedside echocardiography showed cardiac tamponade. Ultrasound-guided pericardiocentesis was carried out using an in-plane technique, at the subcostal region, with a high-frequency linear ultrasound transducer. This particular method provided full visualization of needle trajectory throughout the procedure. It was successfully completed with no complications and patient's hemodynamic status improved post-procedure. He was successfully discharged on day 13. The in-plane subcostal pericardiocentesis is a safe, and simple approach that can be performed in the ED for patients with cardiac tamponade. We recommend this new in-plane method, with high-frequency linear transducer at the subcostal area as an alternative when cardiac window for other approaches cannot be visualized.
Sections du résumé
BACKGROUND
BACKGROUND
Cardiac tamponade occurs when fluid or blood, fills the pericardial space, and causes hemodynamic compromise due to compression of the heart. It is a potentially life-threatening condition, that requires rapid recognition and immediate treatment. Formerly, blind or surgical techniques were used, and it is associated with complications. Medical technology development has enabled us to perform the procedure safely, with the assistance of ultrasound devices. This article will highlight the novel use of an in-plane subcostal technique, as a safe option for pericardiocentesis in cardiac tamponade.
CASE PRESENTATION
METHODS
A 50-year-old man presented to the emergency department (ED) with shortness of breath and shock. He was intubated for respiratory distress. His bedside echocardiography showed cardiac tamponade. Ultrasound-guided pericardiocentesis was carried out using an in-plane technique, at the subcostal region, with a high-frequency linear ultrasound transducer. This particular method provided full visualization of needle trajectory throughout the procedure. It was successfully completed with no complications and patient's hemodynamic status improved post-procedure. He was successfully discharged on day 13.
CONCLUSIONS
CONCLUSIONS
The in-plane subcostal pericardiocentesis is a safe, and simple approach that can be performed in the ED for patients with cardiac tamponade. We recommend this new in-plane method, with high-frequency linear transducer at the subcostal area as an alternative when cardiac window for other approaches cannot be visualized.
Identifiants
pubmed: 35596893
doi: 10.1186/s13089-022-00271-9
pii: 10.1186/s13089-022-00271-9
pmc: PMC9124248
doi:
Types de publication
Journal Article
Langues
eng
Pagination
20Informations de copyright
© 2022. The Author(s).
Références
Emerg Med Clin North Am. 2013 Feb;31(1):117-49
pubmed: 23200331
Catheter Cardiovasc Interv. 2018 Nov 1;92(5):E327-E332
pubmed: 29737598
World J Emerg Med. 2021;12(3):169-173
pubmed: 34141029
Am J Emerg Med. 2013 Sep;31(9):1424.e5-9
pubmed: 23809089
Eur J Echocardiogr. 2001 Mar;2(1):68-9
pubmed: 11882428
J Am Soc Echocardiogr. 2001 Aug;14(8):821-4
pubmed: 11490331
Mayo Clin Proc. 2002 May;77(5):429-36
pubmed: 12004992
Mayo Clin Proc. 1998 Jul;73(7):647-52
pubmed: 9663193
Eur J Echocardiogr. 2000 Mar;1(1):66-71
pubmed: 12086218
Pediatr Cardiol. 2016 Oct;37(7):1328-33
pubmed: 27421844
Eur J Emerg Med. 2018 Oct;25(5):322-327
pubmed: 28509710
N Engl J Med. 2003 Aug 14;349(7):684-90
pubmed: 12917306
Curr Cardiol Rep. 2020 Jun 19;22(8):60
pubmed: 32562136
J Cardiovasc Med (Hagerstown). 2018 Jun;19(6):267-273
pubmed: 29553993